Incidence and Risk Factors of Fracture-Related Infection Following Internal Fixation of Long Bone Fractures

Abstract

Background: Fracture-related infection (FRI) is a significant complication following internal fixation of long bone fractures, contributing to delayed healing and implant failure. This study aimed to determine the incidence and associated risk factors of FRI.

Materials and Methods: This prospective observational study included 150 patients undergoing internal fixation of long bone fractures. Patients were categorized into FRI and Non-FRI groups. Demographic, clinical, fracture-related, and operative factors were evaluated. Statistical significance was considered at p<0.05.

Results: FRI developed in 18 patients (12.0%), while 132 (88.0%) remained infection-free. Infection was significantly higher in open fractures than closed fractures (28.9% versus 6.3%; p<0.001), diabetic than nondiabetic patients (30.0% versus 7.5%; p=0.002), and smokers than nonsmokers (20.8% versus 7.8%; p=0.022). Mean operative duration was significantly longer in the FRI group (132.4 ± 28.6 versus 108.7 ± 25.3 minutes; p=0.003). Staphylococcus aureus was the predominant organism (44.4%). Delayed union occurred in 33.3%, nonunion in 16.7%, and additional surgical intervention was required in 38.9% of infected patients.

Conclusion: Open fractures, diabetes mellitus, smoking, and prolonged operative duration were associated with increased FRI occurrence. Early risk identification and appropriate perioperative management may reduce postoperative complications.